Where did you see yourself?

Where did you see yourself today, 10 years ago?

I've never thought that I wouldn't be a mother. There was never anything more that I wanted to be even as a young girl. But now I see that it may never be in the cards for me. What will life be like for a forever family of two?

I've realized that my prayers have changed. It used to be that I prayed for a child. Now, I am praying for the strength to be ok with whatever comes my way. There's a saying that, "it will be ok in the end, if it's not ok, it's not the end." It's not that I want this to be the end, I just want it to be ok.

Uncertainty and sleepless nights

After a long 5 months, my IVF journey #3 will be coming up very soon. I'm not sure how I feel about this.

I've now met with 2 different doctors not at Ottawa Fertility for a second and third opinion. I had my AMH tested twice, 14.7 pmol/L and 16 pmol/L. Both times at the lower end of normal, but amazing for someone who has such extensive endo and it is still considered normal. So I DO have lots of eggs left... I guess this is somewhat of a comfort. DH's sperm is normal, fragmentation at 22%, which is fair. So basically, all these tests point that everything should have been perfect and does not explain whatsoever why my embryos don't fertilize/grow. Of the 2 cycles I did, I had retrieved a total of 16 eggs of which only 3 fertilized and 1 transferred on day 3. Horrible for a 27 year old. What's going on?

After meeting with Dr. Arthur and Mount Sinai and Dr. Hannam at Hannam Fertility Clinic, I've decided to cycle again with Dr. Hannam. He was so great at looking at my file thoroughly and both DH and I just loved him. We discussed lowering doses and doing a completely new protocol. With lowered doses, we're really hoping to get better quality eggs. I just hope I respond to the stimulation. Expecting to call in CD1 this week. Our treatment plan will be:

PROTOCOL: OCP - controlled Antagonist Cycle Down Regulation: Alesse x 3-7 weeks with endometrial biopsy
Starting Dose: Gonal f 200 once a day with Luveris 75 Add: Lthyroxine 50mcg/day until preg test
Cycle LH Inhibitor: Cetrotide 62.5 to 125 mcg/d
Ovulation Trigger: Ovidrel/HCG x2 sources with 450 IU push prn. Fleet enema prn
Retrieval Day: Standard anaesthesia protocol: fentanyl, midazolam, xylocaine & atropine PRN.
Add serum TSH, T4
Post-Retrieval Day: Prometrium 200mg PV TID with Estrace 2mg PV BID
Male Instructions: 2-4 days of abstinence before expected day of retrieval
LABORATORY INSTRUCTIONS (Lifequest) Fertilization of Eggs: ICSI with fresh sperm SPINDLE VIEW please Assisted Hatching: Yes
Extra Testing: None Plan to Transfer: two embryos on Day 3 or 5 TRANSFER INSTRUCTIONS Pre-Transfer Day: Routine Care
Transfer Day: Full-bladder ultrasound guided embryo transfer. PIO 50mg IM x 1 dose 1 hour prior to transfer
Post Transfer: Serum estrogen, progesterone

My chances seem grim. I'm not sure how I feel about this next cycle. Not sure what I should expect. Maybe I should expect yet another zero fertilization, because that's the worst that could happen. This cycle just may tell us once and for all, if we should even continue down this path. I've been losing a lot of sleep.

New clinic, new doctor, new protocol, new hope? But the shadow of my last two cycles still haunt me.

Getting back on the roller coaster... Maybe?

So much has happened since my last epic IVF failure... It's only been 2 months, but I've had to deal with my last IVF failure, move to a new town due to DH getting a new job, apartment search, take my CMA entrance exam, plus deal with the recent passing of my grandfather. Looking at me the past 2 months, I was a total wreck. I cried myself to sleep almost every night. I cried about my endo, I cried about my IVF failures, I cried about the stress of writing my exam, I cried about not being able to be with my grandfather when he passed away. I couldn't deal. Miraculously, it was my grandfather that gave me back the strength to be normal again.

My grandfather, who lived on the other side of the country, was dying of kidney failure and it was only days until the inevitable. I was dealing with my recent IVF failure and was registered to write my accounting exam just a week after I heard the news. I was devastated to say the least. Sulking, crying, and blaming the world for my woes did nothing. I didn't stop to think about my options to defer or change my test location so I can be with my family. When I got myself together enough to make logical decisions, my grandfather had already past away. Not being able to be with him in his last hours will be something I will regret until the day I die. I wasn't thinking straight. However, I managed to get my act together, change my test location, and fly over to be with my family for his funeral. I broke down as I went home and saw my grandmother sitting in my grandfather's leather chair.

It was the 3 weeks I spent in Vancouver that changed me. Being used to living away from family, being with family after so much has happened was like rain after a long harsh draught. I saw grandpa resting peacefully before he was cremated and it gave me peace, even though it still hurt to lose him. Everyone coming together in a difficult time gave me the strength to be the stronger person. And because my grandmother needed me more, I needed to get back up. So in a way, I've been blessed. I thank my grandpa for it, and I will miss him every day for the rest of my life.


So after 2 months of completely blocking out having infertility treatments from my mind (almost completely... I still do the I-wish-that-was-my-baby-thing whenever I see a lady with a stroller), we've finally went in for a consultation with a new clinic - Mount Sinai. I was nervous, excited, ready to vomit. But despite the anxiety, I mustered up enough strength to actually go to my consultation.

Despite my worst fears, the doctor did not say that I had zero chance of getting pregnant or that I should consider egg donors, but she was willing to investigate the extent of my poor ovarian reserve and maybe try a new protocol. I was also worried about a fluid-filled tube and she was very proactive about it and is also investigating the problem. She ordered AMH to be tested and a second u/s to investigate my tubes. She does believe that my endometriosis is the main cause of my poor egg quality, but thinks that maybe drug dosage and the amount of HSG given to me at trigger also had something to do with my poor egg quality/low number of mature eggs retrieved. She gave me options about what to do with my hydrosalphix and depending on the results of my AMH test, she has a couple of plans of action in mind.

Sounds promising... but I'm not sure what to think of all this. Getting back on the roller coaster is definitely hard but having to live with the fact that I will be child-less for the rest of my life is harder. After my last failure, I was SURE that I wouldn't be ready to try another cycle until next year or perhaps never... I am also booked for a first consultation at yet another clinic, Hannam Fertility, for late August. So until I get my test results and meet with another doctor for a second (third?) opinion... I will settle with being conservatively optimistic!

"Don't worry, you're young... it'll happen when you stop stressing out about it..."

Oh how I hate hearing this...

I feel so distant to all my friends. At this point in their lives, none of them understand what infertility means and most of them doesn't even have the desire to have children yet. It's not their fault, I understand. This is just not something that everyone has to deal with. I am surprised, however, at the lack of knowledge of how our reproduction system works as half of my friends doesn't even know what ovulation means.

How can I expect them to even begin to feel what I have to go through, if they don't even know how the reproductive system works? Ovulation, fertilization, embryos, ovaries, sperm count, fallopian tubes, egg quality, are all like a foreign language to them. It's just too much to take in, and frankly, most of them will probably never have to learn in detail what those words mean. To them, those terms will only be forgotten vocabulary from high school biology. But to us, people dealing with infertility, each and every word have burnt a scar in our hearts.

I have spoken openly about my infertility to all my friends and everyone/anyone who is interested. I have made it my mission to educate them about what infertility is. It's certainly not an easy task. Most people will sympathize with me when I tell them the amount of needles I have to stick myself with through the IVF process, as people can relate to needles and what it feels like when it pierces through our skin.

But of course, the conversation is short-lived, as most people will reply with those dreaded words, "Don't worry, you're young, it will happen" or "Don't stress out! Take a vacation with your husband and it'll happen!" Then they start to lose interest when I try to explain and educate them about infertility. It is so frustrating to me that people just don't want to be educated on the topic. Nevertheless, it will be my mission to heighten infertility awareness as I know there are people out there willing to listen.

Number 2 and complete failure

I wanted to keep myself away from googling/blogging/reading anything IVF related during my second cycle. I wanted to keep myself busy, not thinking about the things that could go wrong. Well, the results are in and I didn't even have a chance.

Protocol: Antagonist estrogen priming (exactly the same as #1)
# Days of stimulation: 12
Follicle count before ER: 11 total, 4 above 17mm, the rest around 15-16.
Eggs retrieved: 6
# fertilized with ICSI: 0
No embryos to transfer

I knew it wasn't good news when it was my doctor and not the nurse that called to give me the stats on fertilization. What a hard blow. I was told that my egg quality was very poor and the embryoligist tried injecting them with sperm anyway but none fertilized. My RE may not recommend another cycle for me.

I was a bit numb and speechless at first, then angry. How was this possible? I'm only 27. I was not told that I had egg quality issues in my first cycle. Yes, only 1 egg made it out of the 10 in the first round, but I thought that was just plain bad luck. I felt completely beat down and lost. I was also told during this cycle that I may have a fluid-filled tube (hydrosalphinx) on the left. To add to my list of problems, now I have egg quality issues.What does this all mean? A second opinion? Surgery? Donor eggs? Adoption? Or giving up all together?

This is all so unfair. The typical 27 year-old wouldn't even be anywhere close to encountering the problems I'm faced with. They'd be having fun, partying, or just enjoying life as newlyweds. Not for me, not for us.

I think people don't realize what a big feat it is to be able to have children. Maybe it was because of my age, being diagnosed with endo and infertility didn't beat me down too much at first. I didn't know what this meant and the long road that would be ahead of me. Even people faced with infertility comes to a realization that "oh my god, this is really happening. It really is THAT difficult." The first time you hear your options and the stats about IUI/IVF, it seemed probable, and trying to pregnant just meant sticking yourself with needles and being probed by an ultrasound stick, instead of the normal routine. "I could get used to that," I thought.

What I can't get used to, is losing your baby after you've been tested positive. Being told that I still have a very good chance of getting pregnant and having that all taken away from me in a second. Who knew this would forever be a part of my history?

It'll take me a while to have it all sink in. In the mean time, I've allowed myself to be all gloom and doom. I thought about my grandparents and what it means to get old, having your health fail you little by little, day by day. I spent a week with my grandparents last month and it opened my eyes to living life in retirement. I can't express the bitter-sweetness of the interdependence that my grandparents have between each other, and the self-less love that my aunt and uncle give each day in caring for my grandparents.

What if I didn't have any loved ones? I have no siblings. No cousins within 2000 miles of me. All my loved ones would have passed when I turn 80. What would my life be like when I'm old without children if my husband were to leave this world before me?  I can not imagine when the day comes that I would need help just to walk across the street and there would be no one there to help me. Would this be my fate?

Sometimes I'd sit by the window, stare out into the world outside my living room, and watch people walk by. What kind of life are they leading? Do they have family and loved ones? Are they happy? Have they mourn the lost of a loved one? What are their dreams and aspirations? My own life would then feel muted as I wonder about the life of others. Somehow this eases the pain but leaves me empty and lost within my own world, looking out behind glass walls.

Taking a step back

Sometimes it feel likes infertility rips my soul from my body and leaves me a disfigured shell of a human being. My soul dangles and clouds over my life as I watch everyone else pass by while I'm trapped waiting behind glass doors. I envision my future but it's just that, a distance dream. Today, I took a step back and I realized that I've started to forget all the wonderful things that I do have in my life. I'm luckiest girl alive to still have them.

To my wonderful husband who has stood by me through thick and thin. I never thought I'd be so lucky to have someone that understands me with just a look. Someone who could finish my sentence and someone who puts up with my insanity. It doesn't  matter what fate throws in our way because in the end, you're my family, you and me. And that's all I need.

For all those times you stood by me
For all the truth that you made me see
For all the joy you brought to my life
For all the wrong that you made right
For every dream you made come true
For all the love I found in you
I'll be forever thankful baby
You're the one who held me up
Never let me fall

You're the one who saw me through through it all
You were my strength when I was weak
You were my voice when I couldn't speak
You were my eyes when I couldn't see
You saw the best there was in me
Lifted me up when I couldn't reach
You gave me faith 'coz you believed

I'm everything I am
Because you loved me

Summary of IVF#1

I feel the need to "summarize" everything that I've been through including the protocol and meds I took, just so I will have this information for myself to reflect on. Perhaps other people may find it interest as well. I guess this is also my way of dealing, closure if you will.


IVF#1 (Nov 2011 - Jan 2012)
Miscarried at 5/6 weeks

Goodbye my little baby~ I wish we could still be together. I wish I could have heard your heart beat. But God had other plans for you. You will be missed. 

Protocol: Antagonist (Patch priming)
Meds:
   Pre-Stim:
     - Estrogen patch: No problem sticking to skin, no side effects felt
     - Orgalutran: Small needle, easy to inject, no burning once I learned how to inject properly
   Stim:
     - 400iu Puregon: Injection by puregon pen, easy to prepare, not too much burning with ice before shot
     - 75iu Repronex: Mixing it was a bit of a hassle, very easy once I got used to it, burns a little after injecting
    # Days of Stimulation: 11 Follicle Count/Size Before Trigger: 3-4 at >17mm, Many smaller ones around 15mm Eggs Retrieved: 10 Mature Eggs: 5 (4 usable, 1 abnormal) Fertilized: 3 (But 2 stopped growing before day 3) Transfered: 1 Day 3 embryo, 8 cell excellent grade Lining: 12mm on day of transfer  Acupuncture: Day of transfer only - once before transfer, and once after
Betas  #1 - 13dp3dt: 11  #2 - 19dp3dt: 324 (Started heavy bleeding)  #3 - 20dp3dt: 157 (Continued bleeding)  #4 - 24dp3dt: 27 (Continued light bleeding)  #5 - 30dp3dt: Not sure yet but probably back to zero

I know I started my first cycle pretty optimistic. It's probably the way all first timers feel. However, the reality is that this is not going to work the first time for everybody. The hardest part about my first cycle was that it ended in miscarriage. Honestly, I'm still coping. This cycle really brought me down to earth about my expectations and it was a hard kick in the ass reality check. The next round will hopefully be easier now I know what to expect. It won't be less stressful but I hope to cycle again soon and I will not give up! "It will be ok in the end! If it's not ok, it's not the end!" - Oprah

What else can I say about my first cycle? Well, Beans is sure happy that he's going to stay an only child (fur-child) for a while. I know he's smirking behind my back....